Jaime Enrique Moreno, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R1589 Issued in TX

Practice address

2455 NE Loop 410 Ste 100
San Antonio, TX 78217-5650

Phone

(210) 599-6000

Fax

(210) 599-7519

NPI assigned

Apr 9, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jaime Enrique Moreno Professional name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Texas Medical School at San Antonio, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Privia Medical Group Gulf Coast, PLLC

  • Obstetrics & Gynecology Physician
  • Houston, TX
  • NPI 1578969465
  Medicare reassignment Care Compare group
• Erik Garcia FNP-C PLLC

  dba Garcia Family Medicine & Weight Loss Clinic

  • Family Nurse Practitioner
  • El Paso, TX
  • NPI 1285353045
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1952720781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 NE LOOP 410 STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175650",
            "telephone_number": "210-599-6000",
            "fax_number": "210-599-7519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 NE LOOP 410 STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175650",
            "telephone_number": "210-599-6000",
            "fax_number": "210-599-7519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "JAIME",
        "middle_name": "ENRIQUE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-09",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R1589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAIME",
            "last_name": "MORENO",
            "middle_name": "ENRIQUE",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Hannah Nicole Moreno, MS
• Isabel Cristina Moreno, LVN
• Jacel Hernandez Moreno, BSN,RN
• Jacqueline Moreno, MD
• Jaime Moreno, MD
• Jennifer Moreno
• Jennifer Moreno, M.S., CCC-SLP
• Jessica Anne Moreno, RN
• Jessica Celeste Moreno
• Joanna Marie Moreno, RN

• Family Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.